Topic Overview
- Prostate cancer is common among men older than
65. Most cases are treatable because they are found with screening tests before
the cancer has spread to other parts of the body. Most men do not die from
it.
- The most common way to check for prostate cancer is to have a
digital rectal exam and a prostate-specific antigen (PSA) blood test. A higher
level of PSA may mean prostate cancer, but it could also mean an enlargement or
infection of the prostate.
- Experts disagree on whether regular PSA
testing is right for all men. Testing could lead to cancer treatment that can
cause other health problems, especially loss of bladder control and not being
able to have an erection. The decision to have a PSA test for prostate cancer
depends on your doctor's opinion and your preferences.
- Because
other problems can also cause your PSA to be high, your doctor may do a biopsy
to figure out the cause. A biopsy means your doctor takes a sample of tissue
from your prostate gland and sends the sample to a lab for
testing.
- Choosing treatment for prostate cancer can be confusing.
You and your doctor may decide to treat your cancer with surgery or radiation.
Or, if the cancer has not spread, you may be able to wait and watch to see what
happens. During watchful waiting, you will have regular checkups with your
doctor to see if your cancer has changed.
Is this topic for you?
For information on cancer that has come back or spread to other
parts of the body, see the topic
Prostate Cancer, Advanced or Metastatic.
What is prostate cancer?
Prostate cancer is the abnormal growth of cells in a man's
prostate
gland 
. The prostate sits just below the bladder. It makes part of the
fluid for
semen. In young men, the prostate is about the size of
a walnut. It usually grows larger as you grow older.
Prostate cancer is common in men older than 65. It usually grows
slowly and can take years to grow large enough to cause any problems. Most
cases are treatable, because they are found with screening tests before the
cancer has spread to other parts of the body.1
Although most men may die with prostate cancer, most men
do not die from it.
Experts don't know what causes prostate cancer, but they believe
that your age, family history (genetics), and race affect your chances of
getting it. Eating a high-fat diet may also play a part.2
What are the symptoms?
Prostate cancer usually does not cause symptoms in its early
stages. Most men don't know they have it until it is found during a regular
medical exam.
When problems are noticed, they are most often problems with
urinating. But these same symptoms can also be caused by an enlarged prostate
(benign prostatic hyperplasia). An enlarged prostate is
common in older men.
See your doctor for a checkup if:
- You have trouble starting your urine
stream.
- You have a weaker-than-normal urine stream.
- You
cannot urinate at all.
- You have to urinate often.
- You
feel like your bladder is not emptying completely when you
urinate.
- You have to get up at night to urinate.
- You
have pain or burning when you urinate.
- You have blood in your
urine.
- You have a deep pain in your lower back, belly, hip, or
pelvis.
How is prostate cancer diagnosed?
The most common way to check for prostate cancer is to have a
digital rectal exam, in which the doctor puts a
gloved, lubricated finger in your rectum to feel your prostate, and a
prostate-specific antigen (PSA) blood test. A higher
level of PSA may mean that you have prostate cancer, but it could also mean
that you have an enlargement or infection of the prostate.
If your PSA is high, or if your doctor finds anything in the
rectal exam, he or she may do a
biopsy to figure out the cause. A biopsy means your
doctor takes a sample of tissue from your prostate gland and sends it to a lab
for testing.
Because many men have regular checkups, about 9 out of 10
prostate cancers are found in the early stages. The 5-year survival rate is
almost 100%.1 The 5-year survival rate shows the
percentage of men still alive 5 years or longer after diagnosis. It’s important
to remember that everyone’s case is different, and these numbers may not show
what will happen in your case.
Should you have regular tests for prostate cancer?
It is important to have regular health checkups, including a
digital rectal exam. But experts disagree on whether regular PSA testing is
right for all men. Testing could lead to cancer treatment that can cause other
health problems, especially loss of bladder control and not being able to have
an erection.
Talk with your doctor about the reasons for and against having a
PSA test for prostate cancer. The decision to have a PSA test depends on your
doctor's opinion and your preferences.
How is prostate cancer treated?
Your treatment will depend on what kind of cancer cells you have,
how far they have spread, your age and general health, and your
preferences.
You and your doctor may decide to treat your cancer with
surgery, radiation, hormone therapy, or a combination. Or, if the cancer has
not spread and you are around age 70 or older, you may be able to
wait and watch to see what happens. During watchful
waiting, you will have regular checkups with your doctor to see if your cancer
has changed.
Choosing treatment for prostate cancer can be confusing. Talk
with your doctor to choose the treatment that is best for you.
How can treatment affect your quality of life?
Both surgery and radiation can cause
urinary incontinence (not being able to control
urination) or impotence (not being able to have an erection).
Nerves that help a man have an erection are right next to the
prostate. Surgery to remove the cancer may damage them. Many times a special
form of surgery, called nerve-sparing surgery, can be used to try to avoid
damaging the nerves. But if the cancer has spread to the nerves, they may have
to be removed during surgery.
These same nerves can also be damaged by the X-rays that are
used in radiation therapy.
Drugs and mechanical aids may help men who are impotent because
of treatment. Many men recover their ability to have an erection several months
or years after surgery.
Frequently Asked Questions
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Being diagnosed:
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Health Tools
Health tools help you make wise health decisions or take action to improve your health.
Cause
The exact cause of
prostate cancer is not known, but experts believe that
your age and family history (genetics) may have something to do with your
chances of getting the disease. Eating a high-fat diet may add to your chances
of getting it.2
The prostate usually gets larger as you age. Having an enlarged
prostate (benign prostatic hyperplasia, or BPH) is very common
among older men and does not increase your chances of developing prostate
cancer. However, an enlarged prostate is sometimes caused by prostate cancer
instead of BPH.
Symptoms
Prostate cancer usually doesn't cause symptoms in its
early stages. Between 60% and 70% of men who are older than 80 who have
prostate cancer have no symptoms.3
When there are symptoms, they may include:
- Having difficulty starting your urine stream.
This is called hesitancy.
- Having a weaker-than-normal urine
stream.
- Not being able to urinate at all.
- Having to
urinate often.
- Feeling that your bladder is not emptying completely
when you urinate.
- Having to get up at night to urinate. This is
called nocturia.
- Having pain or a burning feeling when you urinate.
This is called dysuria.
- Having blood in your urine. This is called
hematuria.
- Having blood in your
semen. This is called
hematospermia.
- Having a deep pain in your lower back, abdomen, hip,
or pelvis.
These symptoms may also be caused by:
-
Benign prostatic
hyperplasia (BPH), which is an enlarged prostate. This is very common in
older men. The prostate usually grows larger with age. When it gets large
enough, it can press against the urethra—the tube that carries urine from the
bladder through your penis—and cause bladder problems.
-
Prostatitis, an
infection in the prostate.
-
Urinary tract
infection, an infection in any of the organs that make urine or the
tubes that carry it out of the body.
Symptoms that may indicate the cancer has spread, or metastasized,
to other parts of the body include:
- Weight loss.
- Bone pain, especially
in the lower abdomen, hip, pelvis, or lower back.
- Swelling in the
legs and feet.
For more information about prostate cancer that has come back or
spread, see the topic
Prostate Cancer, Advanced or Metastatic.
What Happens
Almost all
prostate cancers are discovered in their early stages,
and the 5-year survival rate is almost 100% when the cancer is found at an
early stage.1 The 5-year survival rate is the
percentage of men who are still alive 5 years after they have been diagnosed.
It is just an average. Everyone's case is different, and this number does not
show what will happen in your case.
Prostate cancer is so common that some experts believe that every
man would get it if he lived long enough. Studies of autopsies show that most
men older than 85 who die of other causes have tumors in their
prostates.4 It usually is a very slow-growing cancer
that takes years to grow large enough to cause any problems. Sometimes, though,
it grows quickly.
When prostate cancer spreads, it goes first to surrounding tissues,
then to lymph nodes in the pelvis, and then on to the bones, lungs, or other
organs. For more information, see the topic
Prostate Cancer, Advanced or Metastatic.
What Increases Your Risk
Being older than 50 is the main risk factor for
prostate cancer. A risk factor is anything that makes
you more likely to get a particular disease. More than 65% of new prostate
cancers are diagnosed in men who are older than 65.1
In addition, 90% of prostate cancer deaths occur in men who are older than
65.5
Your chances of getting the disease are higher if other men in your
family have had it. Your risk is doubled if your father or brother developed
prostate cancer. Your risk increases even more if those relatives were
diagnosed before they were 55.4 However, most men who
get prostate cancer have no family history of the disease.
Race and prostate cancer survival
Black men have a bigger chance of getting the kind of prostate
cancer that grows and spreads. Researchers are not sure why there is a
difference in disease and death rates among different races. Some experts think
there may be a genetic link. Some research suggests that access to health care
may play a role in survival rates.6
Ethnicity and 5-year survival rate
(percentage of men with prostate cancer who survive for 5 years or
longer)7
Survival rates
| Diagnosis | White | Black |
|---|
| Cancer that has not spread | 95% | 88% |
| Locally advanced cancer | 87% | 69% |
| Metastatic cancer | 30% | 23% |
The 5-year survival rate shows the percentage of men who are
still alive 5 years or more after they are diagnosed. It is important to
remember that these are only averages. Everyone’s case is different, and these
numbers do not show what will happen in your case.
Asian-American men develop prostate cancer more often than Asian
men living in Japan and China. However, the incidence of prostate cancer in
Asian-American men is lower than that of white men and much lower than that of
African-American men. A Western high-fat diet may be the cause.2
Other factors that may increase your risk
- A high-fat diet. Studies that compare
prostate cancer rates have found that men who live in countries where high-fat
diets are common are more likely to be diagnosed with and die from prostate
cancer than men who live in countries where low-fat diets are common.2
-
Hormones. Researchers are studying the
link between high
testosterone levels and prostate cancer.6
- Exposure to cadmium, through smoking, diet, and workplaces such
as ore smelters or factories where nickel-cadmium batteries are made. Cadmium
is a chemical that has been linked to prostate cancer by early studies, but
newer studies are less clear about the connection.7
When To Call a Doctor
Call your doctor immediately if you:
- Are completely unable to
urinate.
- Have painful urination and a fever higher than
100
°F (38
°C), chills, or body
aches.
- Have blood or pus in your urine.
Call your doctor if you have painful urination and signs of a
possible
urinary tract infection that last longer than 24
hours. These signs include:
- A burning sensation while
urinating.
- Pain in your lower back just below your ribs that is not
related to any injury or physical exertion.
- Painful
ejaculation.
- Difficulty starting or controlling your
urination.
Call your doctor to schedule an appointment within 1 to 2 weeks if
you have unexplained:
- Weight loss.
- Dull, aching pain in
your lower back, hip, or pelvis.
In most men, the
prostate
gland gets larger as they get older. Having symptoms of an enlarged
prostate does not mean you have cancer, but you should be checked by your
doctor. Symptoms of an enlarged prostate include difficulty urinating and
sexual dysfunction, among others. For more information on an enlarged prostate,
see the topic
Benign Prostatic Hyperplasia (BPH).
Watchful Waiting
Watchful waiting means waiting to see what happens to
your
prostate cancer without treatment.
- The main reason to choose watching and
waiting is to avoid the potentially serious side effects of
surgery or
radiation. With treatment there is a chance that you
will have erection problems and bladder problems and also a small chance that
you will have bowel problems. Some men whose cancer has been caught in its
early stages choose to watch and wait because most prostate cancer grows
slowly. This choice makes the most sense for some men in their 70s or 80s or
men who are in poor health.
- The main reason to choose treatment
(and not watchful waiting) is that it makes the cancer much less likely to grow
and spread.8
During watchful waiting, you have regular
digital rectal exams and
PSA tests to check the growth of your cancer. As long
as there is no change, you may continue to watch and wait. If the cancer begins
to grow rapidly or spread, you may consider other treatment.
Who To See
The following health professionals can evaluate urinary
symptoms:
The following doctors treat prostate cancer:
To prepare for your appointment, see the topic Making the Most of Your Appointment
Exams and Tests
If you are having problems urinating, your doctor may use tests to
see if you have an enlarged prostate (benign prostatic
hyperplasia). This condition is the most common cause of urination
problems.
Initial tests include:
- A
digital rectal exam, in which the doctor inserts a
gloved finger into your rectum to feel your prostate gland. Some prostate
tumors can be found this way.
- A
urine test, in which some of your urine is sent to a
lab and checked for blood, infection, or abnormal cells.
Prostate cancer can cause blood in the
urine.
- A
PSA test to measure the levels of prostate-specific
antigen (PSA) in your blood. A higher level of PSA may be a sign of an
enlargement, infection, or cancer of the prostate. If it is possible that an
infection is raising your PSA, you may first have 4 to 6 weeks of
antibiotics. Your doctor may suggest a second PSA test
before thinking of doing a biopsy.
- AUA symptom score. This is a
series of questions from the American Urological Association (AUA) that
measures how bad your urinating problems are. Sometimes these problems are
caused by prostate cancer that is blocking your urine flow.
- Urine-flow rate test. This test measures your urine and how fast
it comes out. Sometimes a low flow rate is caused by prostate cancer.
If tests point to prostate cancer, your
doctor may recommend a
prostate biopsy, in which tissue is taken from the
prostate and examined under a microscope. A biopsy is the only way to confirm
whether you have prostate cancer.
After treatment for prostate cancer, you
have regular checkups to check for any signs that the cancer has come back or
spread. Tests that are done to evaluate the spread of the cancer and to plan
further treatment may include:
- Blood tests. Different types of blood tests are
used to see whether cancer has spread to your bones or liver.
- A
bone scan. Radioactive material that shows up on
X-rays is injected into your arm. An X-ray camera passes over your body, taking
pictures as the radioactive material moves into your bones. Areas of bone
damage show up in the pictures. Prostate cancer that has spread to the bones
can cause this kind of damage.
- A
CT scan. A CT scanner directs a series of X-rays
through your body. CT scans can show tissue damage or diseases, such as an
infection or tumor.
- A pelvic lymphadenectomy. This is an operation
in which the
lymph
nodes near your prostate are removed and checked under a microscope to
see if they contain cancer. It may be done at the same time as surgery to
remove your prostate.
- An
MRI. An MRI uses a strong magnetic field to make
pictures of the prostate. The MRI can show tissue damage or disease, such as
infection or a tumor.
- ProstaScint scan. This scan may be used to
look for cancer cells after you have had surgery to remove cancer. Radioactive
material that attaches itself to prostate cancer cells and shows up on X-rays
is injected into a vein. Four days later, your body is scanned with a special
camera, and lymph nodes and other areas that have been invaded by prostate
cancer cells show up in the picture.
-
PET scan.
This kind of scanner produces 3-D images that give a better view of tumors.
Rarely, it is used to look at advanced prostate cancer.
Early Detection
Screening for prostate cancer—checking for signs of the disease
when there are no symptoms—is done with the
digital rectal exam and the
PSA test. In the United States, about 75% of men who
are age 50 or older have had a PSA test.9
-
Should I have a PSA test to screen for
prostate cancer?
The number of deaths caused by prostate cancer has dropped over
the past 20 years. This has been linked to more early diagnosis with PSA
testing and to better cancer treatment.1
Finding prostate cancer early leads you to some big decisions.
Most prostate cancer grows slowly. And the side effects of treatment can change
your quality of life—mainly not being able to have an erection (impotence) and
not being able to control urination (incontinence). If you are around age 70 or
older, these side effects may seem worse than early-stage cancer that may not
grow much during your lifetime. But, especially for men 65 or younger,
treatment makes the cancer less likely to grow and spread.8
Because your age and condition are unique, it is important to
learn all you can and talk to your doctor before making a decision.
What to think about
It is expected that prostate cancer will account for 33%
(234,460) of new cancer cases in men in the United States in 2006. About 90% of
those will be discovered in the early stages, and the overall 5-year survival
rate for men whose cancer is found early is almost 100%.1
Treatment Overview
Prostate cancer is often curable. About 90% of new cases of
prostate cancer are caught early. Almost 100% of men with these early cancers
survive 5 years or more after being diagnosed.1
Choosing treatment for
prostate cancer can be confusing. Not all men are
treated the same way. Any treatment can cause serious side effects.
You and your doctor have two choices: You can treat your cancer,
most likely with surgery or radiation, or you can wait and watch to see what
happens.
Watchful waiting may be a good option if you are
around age 70 or older. During watchful waiting, you have regular checkups with
your doctor to see if your cancer has changed.
In general, healthy men who are younger than 60 and whose cancer
has not spread are treated with surgery or radiation. Surgery removes the
prostate gland and its cancer. Radiation destroys the cancer and may damage
nearby healthy cells. With these treatments, there is a chance of having
erection problems, some chance of having urine leakage problems, and a small
chance of having bowel problems.
Because of these side effects, some men, especially some older men,
may decide that the cure is worse than the disease. Studies show that some men
are willing to accept the risk of a shorter life span in return for a better
quality of life than what they would have with treatment.10
Your treatment decision will depend on:
- Your age, overall health, and life expectancy.
- Your
PSA level.
- What kind of cancer cells you
have. This is called the
grade or Gleason score of your cancer. Most prostate
cancer cells grow very slowly, but some types of cells grow quickly and spread
to other areas of the body.
- How far your cancer has spread. This
is called the
stage of your cancer.
- The side effects of
treatment.
- Your personal feelings and concerns.
Prostate cancer is curable if it is discovered and treated early.
Unlike many other cancers, it is usually slow-growing. Most men will die
with prostate cancer but not of
prostate cancer. This slow growth means you have time to learn all you can
before deciding whether to have treatment or which treatment to have.
Initial treatment
There are three main choices for treating
prostate cancer: surgery, radiation, and watchful
waiting, also called observation.
Surgery involves removing the cancer by
removing the prostate gland. This operation is called a
prostatectomy. Before removing the prostate, the
surgeon may remove some
lymph nodes in the area to see if the cancer has
spread.
There are nerves along the side of the prostate that affect your
ability to have an erection. Sometimes these nerves are removed along with the
prostate to make sure that all the cancer is removed. Sometimes a surgeon may
be able to avoid damaging those nerves; this is called nerve-sparing surgery. The surgeon will only do that if he or
she feels sure that there is little chance of leaving some cancer cells
behind.
Studies show that fewer side effects are reported at large
medical centers, where the surgeons do prostatectomies more often and so are
more experienced and skilled.2
Age is not a reason to avoid surgery. However, if you are 70 or
older, other medical conditions, such as
heart disease, may affect your decision. This is
especially important if you have early-stage cancer, which generally grows
slowly.
External radiation.
Radiation therapy uses high-energy rays, such as
X-rays, to destroy the cancer. It is usually given 5 times a week for 4 to 8
weeks. Each treatment lasts only a minute or two. Radiation destroys tissue, so
it may damage the nerves along the side of the prostate that affect your
ability to have an erection.
Internal radiation (brachytherapy).
Brachytherapy is a one-time radiation treatment that uses tiny radioactive
seeds. A needle is used to inject the seeds into your prostate, where they
slowly release radiation directly into the cancer.
Hormone therapy is sometimes used with
radiation treatment. Less often, it is used by itself. Taking a hormone-therapy
drug lowers your level of
testosterone and other male hormones. A prostate tumor
usually needs male hormones to survive. This is why hormone therapy can cause
the tumor and the prostate to shrink.
Watchful waiting.
Watchful waiting is a treatment choice, especially
among men who are in their 70s or older. This is a period of time during which
you are checked and tested regularly by your doctor but you are not being
treated. This choice may be good if you are in your later years, tests show
your cancer has been caught early and is the slow-growing kind, and you do not
want to have the side effects of surgery or radiation.
The side effects of treatment are
important to think about. Removing the prostate gland during surgery can cause
impotence (not being able to have an erection) and
urinary incontinence (not being able to control
urination). Destroying the prostate gland with radiation may cause impotence
and incontinence, but not as much as surgery can. However, radiation sometimes
causes diarrhea and bowel problems.2 Hormone therapy
can cause loss of sex drive and erections, risk of weak bones (osteoporosis),
hot flashes, and weight gain.
The ability to have an erection sometimes returns or at least
improves over time. So does the ability to control urine leakage.
-
Should I have a prostatectomy or radiation
therapy to treat localized prostate cancer?
A diagnosis of
prostate cancer usually means that you will be seeing
your doctor regularly for years to come, so it is a good idea to develop a
relationship that is based on full and honest information. Ask your doctor
questions about your cancer so that you can make the
best decision about treatment. Your doctor also may give you some advice on
changes to make in your life to help treatment be successful.
Your treatment options will be different if you are diagnosed
with prostate cancer that has come back or has spread outside the prostate. For
more information, see the topic
Prostate Cancer, Advanced or Metastatic.
Dealing with your emotions
You may feel many different emotions after being diagnosed with
prostate cancer. Most men feel some denial, anger, and grief. Others may have
fewer emotions. There is no "normal" or "right" way to react. There are many
things you can do to help yourself deal with your
emotional reaction to prostate cancer. Talking with
family and friends helps some people. Others find that they need to spend time
alone.
If your reaction is interfering with your ability to make
decisions about your health, it is important to talk to your doctor. Your
cancer treatment center may offer psychological or financial services. You may
also contact your local chapter of the American Cancer Society to help you find
a support group. Talking with other men who have had similar feelings can be
very helpful.
For more information about specific treatments, see the following
topics:
Ongoing treatment
If you choose
surgery or
radiation to treat your
prostate cancer , it will be important to have regular
checkups. If your cancer comes back, this will help your doctor catch it early.
It will also help your doctor treat any complications you may have from your
treatment. Your regular follow-up program may include:
- Physical exams.
-
PSA
tests, to measure the levels of prostate-specific antigen (PSA) in your
blood. A higher level of PSA may indicate an enlargement, infection, or cancer
of the prostate. A rising PSA level after treatment for prostate cancer can
mean your cancer has come back.
-
Digital rectal
exams, to check for changes in and around your rectum.
-
Urinalysis, to check for blood in your
urine.
-
Biopsies, to examine suspicious
tissue.
Prostate cancer and its treatment also may cause nausea, pain, or
other side effects. You can use
home
treatment to manage some of these side effects. If you experience
nausea, wait for 1 hour after vomiting has stopped and
then sip a
rehydration drink to restore lost fluids and
nutrients.
Constipation and
diarrhea may be eased if you drink enough fluids.
For more information about managing pain, see the topic
Cancer Pain.
If you decide to
watch and wait instead of having treatment, you will
have regular checkups with your doctor to keep an eye on your cancer. You will
have digital rectal exams and PSA tests every 3 to 6 months. It is possible
that a curable cancer could spread and become incurable during a 6-month
period, but this is not common. If there is no change in your condition, you
may continue to watch and wait. If the cancer begins to grow or spread, you may
consider medications, surgery, or radiation.
Treatment if the condition gets worse
For information on
prostate cancer that spreads or comes back, see the
topic Prostate Cancer, Advanced or Metastatic.
What To Think About
Cryosurgery freezes the prostate gland to kill the
cancer. It can be used to treat early prostate cancer. But cryosurgery is not a
top treatment choice—more research is needed. Compared with radiation
treatment, cryosurgery may be more likely to cause
impotence. (But this is common with both treatments.) Like radiation,
cryosurgery does not always keep cancer from coming back.11
Researchers also are studying ways to kill cancer cells with
heat. One treatment being studied is high-intensity focused
ultrasound, or HIFU. The sound waves produced by HIFU are 10,000 times
stronger than regular ultrasound. The sound waves are aimed at the prostate and
its cancer, and the intense heat destroys the prostate. Other forms of heat
treatment under study use electrodes, microwaves, and magnetic metal rods to
heat and destroy the prostate.
Prevention
You can take steps that may lower your chances of getting
prostate cancer.10
Eat more low-fat, high-fiber foods, such as:
- Soy products, like tofu and soy
beans.
- Tomatoes and foods that contain tomato
sauce.
- Vegetables, like broccoli, cauliflower, and cabbage.
Researchers are looking into other things that may help prevent
prostate cancer. More research is needed in all these areas.
- Finasteride is a pill that is used to treat
enlarged prostates. It prevents prostate cancer from starting in 1 out of 4 men
(25%). But men who take finasteride and do get prostate
cancer may have a higher risk of getting more serious (high-grade) tumors than
normal.12
- Taking a
nonsteroidal anti-inflammatory drug (NSAID) every day
may help protect men who are 60 or older from prostate cancer.13
- One recent study suggests that drinking red wine
may prevent some prostate cancer.14
Researchers are studying the possibility that vitamins D and E,
selenium, and green tea may help prevent prostate cancer.
Home Treatment
During any stage of
prostate cancer, there are things you can do at home
to help manage the side effects of cancer or treatment. See the following tips
for managing:
-
Nausea or vomiting. After vomiting has
stopped for 1 hour, sip a
rehydration drink to restore lost fluids and
nutrients. Watch for and treat early signs of
dehydration. Older adults can quickly become
dehydrated from vomiting.
-
Pain. You may wish to try taking
aspirin or
similar drugs or an alternative therapy such as
biofeedback to help relieve your pain. Be sure to
discuss any home treatment you use for pain with your health professional.
-
Diarrhea. Do not eat until you are feeling better.
Take small sips of water or a rehydration drink often and small bites of salty
crackers. Begin eating mild foods (such as rice, dry toast or crackers,
bananas, broth, and applesauce) the next day or sooner, depending on how you
feel.
-
Constipation. Make sure you drink enough liquids. Most
adults should drink 8 to 10 glasses of water, or noncaffeinated beverages each
day. Include fruits, vegetables, and fiber in your diet each day.
-
Sleep problems. Often, simple measures such as having
a regular bedtime, getting some exercise during the day, and avoiding naps can
help sleep problems.
-
Urinary problems. Home treatment for
urinary incontinence includes eliminating caffeinated drinks from your diet and
establishing a schedule of urinating every 3 to 4 hours, regardless of whether
you feel the need. Try doing
pelvic floor (Kegel) exercises to strengthen your
pelvic muscles.
During your treatment, you may experience emotional problems. See
the following tips for managing:
-
Stress. Expressing your feelings to
others may help you understand and cope with them. Learning relaxation
techniques may also be helpful.
-
Poor body image.
Your feelings about your body may change after treatment for cancer. Talk
openly about your concerns with your partner, and discuss your feelings with
your doctor, who may also be able to refer you to organizations that can offer
additional support and information.
Healthy habits such as eating right and getting enough sleep and
exercise can help control your symptoms.
You should not have to accept pain as part of receiving cancer
treatment or having cancer. For tips on pain management, see:
-
Controlling cancer pain.
Medications
Hormones are drugs that can affect the growth of
prostate cancer cells. They sometimes are used along
with radiation treatment to help make sure that all cancer cells are
destroyed.
Chemotherapy is the use of powerful drugs—either
injected or taken as pills—to destroy cancer cells. While many men decide to
have chemotherapy for treatment of late-stage prostate cancer, researchers are
studying whether chemotherapy should be used before or after surgery to treat
early-stage, high-risk prostate cancer.10
Surgery
Surgery is one of two main treatments for early-stage
prostate cancer; radiation is the other. Surgery may
be done to remove the prostate and its cancer. It may done to remove and test
lymph nodes in the area to see whether the cancer has
spread. It also may be done to fix urinary problems that are caused by a tumor
pressing on the
urethra.
The
stage of your prostate cancer along with your age and
general health will affect the type of surgery you choose.
Surgery
Radical prostatectomy is an operation to remove the
entire prostate and any nearby tissue that may contain cancer. It can be done
as open surgery through a large incision (cut) in the belly, or as
laparoscopic surgery through several very small
incisions in the belly. Laparoscopic surgery is done with a tiny camera and
special instruments to remove the prostate. Sometimes lymph nodes in the area
also are removed so that they can be checked for signs of cancer. This is
called a
lymph node biopsy.
What To Think About
Laparoscopic surgery is most often done by hand. A few doctors
now do it by guiding robotic arms that hold the surgery tools. This is called
robot-assisted prostatectomy. This technology is not yet
widely used.
Removing the prostate can cause erection problems and bladder
problems. But for many men, these problems get better over time.
Surgery may completely remove your prostate cancer. However, it
is not possible to know for sure before surgery whether the cancer has spread
beyond the prostate, where it cannot always be cured with surgery alone.
Other Treatment
Radiation therapy may be used alone or combined with
hormonal treatment or surgery to treat
prostate cancer. Like surgery, it is most effective in
treating cancer that has not spread outside the prostate. When combined with
surgery, radiation is used to destroy any cancer cells that might be left
behind and to relieve pain when the cancer has spread.
Other Treatment Choices
There are two main types of radiation treatment for prostate
cancer:
- External beam radiation, in which a machine
aims high-energy X-rays at the cancer from outside the
body.
- Brachytherapy, in which tiny seeds containing radioactive
material are injected directly into or near the cancer and left there. In time,
the material loses its radioactivity and the seeds can remain where they
are.
What To Think About
Radiation treatment may cause erection problems and
bladder problems. It sometimes causes diarrhea. The
ability to have an erection sometimes returns or at least improves over time.
So does the ability to control urination.
Clinical trials are going on to find ways to prevent,
detect, diagnose, and treat prostate cancer. For example, researchers are
studying whether vitamin E and selenium, which is a mineral found in certain
foods, can prevent prostate cancer.
Researchers also are testing many new ways to treat prostate
cancer using the body's
immune system to destroy the cancer cells. This type
of treatment is called immunotherapy. Much has been
learned in the past 20 years about the body's ability to attack prostate cancer
cells with help from the outside, and research is still being done in this
area. This type of treatment either stimulates your immune system or adds to
it, for example, by giving you immune cells from another person.
Other Places To Get Help
Online Resource
| Malecare |
| Web Address: | http://www.malecare.com |
| |
Malecare.com is a nonprofit group of experienced patients and
doctors, many of whom have been diagnosed with prostate cancer or testicular
cancer, writing weekly updates on treatment choice strategies and how to live
with the consequences of those choices. Information is available in English,
Italian, Spanish, Russian, Hebrew, Portuguese, and French. |
|
Organizations
| American Cancer Society |
| Phone: | 1-800-ACS-2345 (1-800-227-2345) |
| Web Address: | www.cancer.org |
| |
The American Cancer Society conducts educational programs and
offers many services to people with cancer and to their families. Staff at the
toll-free number have information about services and activities in local areas
and can provide referrals to local ACS divisions. |
|
| American Urological Association |
| 1000 Corporate Boulevard |
| Linthicum, MD 21090 |
| Phone: | 1-866-RING AUA (1-866-746-4282) toll-free (U.S. only)
(410) 689-3700 |
| Fax: | (410) 689-3800 |
| E-mail: | aua@auanet.org |
| Web Address: | http://www.auanet.org, http://www.urologyhealth.org |
| |
The American Urological Association (AUA) is an educational
nonprofit organization that conducts activities to help members stay current on
the latest research and best practices in the field of urology. The AUA
provides a public education Web site as well as a wide range of services for
members. |
|
| National Cancer Institute (NCI) |
| NCI Publications Office |
| 6116 Executive Boulevard |
|
Suite 3036A |
| Bethesda, MD 20892-8322 |
| Phone: | 1-800-4-CANCER (1-800-422-6237) 9:00 a.m. to 4:30 p.m. EST, Monday through Friday |
| TDD: | 1-800-332-8615 |
| E-mail: | cancergovstaff@mail.nih.gov |
| Web Address: | http://www.cancer.gov (or
https://cissecure.nci.nih.gov/livehelp/welcome.asp# for live help
online) |
| |
The National Cancer Institute (NCI) is a U.S. government agency
that provides up-to-date information about the prevention, detection, and
treatment of cancer. NCI also offers supportive care to people with cancer and
to their families. NCI information is also available to doctors, nurses, and
other health professionals. NCI provides the latest information about clinical
trials. The Cancer Information Service, a service of NCI, has trained staff
members available to answer questions and send free publications.
Spanish-speaking staff members are also available. |
|
| National Prostate Cancer Coalition |
| 1154 Fifteenth Street, Northwest |
| Washington, DC, 20005 |
| Phone: | 1-888-245-9455 (toll-free)
(202) 463-9455 |
| Fax: | 202-463-9456 |
| E-mail: | info@fightprostatecancer.org |
| Web Address: | http://www.fightprostatecancer.org |
| |
This organization works to reduce the number of cases of prostate cancer
through awareness, outreach, and advocacy. The organization also works with
government officials to increase federal funding for prostate cancer
research. |
|
| Us Too! International |
| 5003 Fairview Avenue |
| Downers Grove, IL 60515 |
| Phone: | 1-800-80-UsToo (1-800-808-7866)
(630) 795-1002 |
| Fax: | (630) 795-1602 |
| E-mail: | ustoo@ustoo.org |
| Web Address: | http://www.ustoo.com |
| |
Us Too! International is an independent, charitable network of
support groups for men with prostate cancer and their families. Us Too! groups
offer fellowship, peer counseling, education about treatment options, a
newsletter, and information about medical alternatives. The national
organization can provide information about support groups and activities in
your area. |
|
Related Information
References
Citations
American Cancer Society (2006). Cancer Facts and Figures 2006, pp. 1–56. Atlanta: American
Cancer Society. Available online: http://www.cancer.org/docroot/STT/stt_0.asp.
Kantoff PW (2002). Prostate cancer. In DC Dale, DD
Federman, eds., Scientific American Medicine, section
12, chap. 9. New York: WebMD.
Carter HB, Partin AW (2002). Diagnosis and staging of
prostate cancer. In PC Walsh et al., eds., Campbell's
Urology, 8th ed., vol. 4, pp. 3055–3079. Philadelphia:
W.B. Saunders.
Gronberg H (2003). Prostate cancer epidemiology.
Lancet, 361(9360): 859–864.
U.S. Preventive Services Task Force (2003). Screening
for prostate cancer: Recommendations and rationale. American
Family Physician, 67(4): 787–792.
Reiter RE, deKernion JB (2002). Epidemiology, etiology, and prevention of prostate cancer. In PC Walsh et al., eds., Campbell's Urology, 8th ed., vol. 4, pp. 3003–3024. Philadelphia: W.B. Saunders.
National Cancer Institute (2005). Prostate Cancer (PDQ): Prevention—Health Professional Version.
Available online:
http://www.nci.nih.gov/cancertopics/pdq/prevention/prostate/HealthProfessional/page3.
Bill–Axelson A, et al. (2005). Radical prostatectomy
versus watchful waiting in early prostate cancer. New England
Journal of Medicine, 352(19): 1977–1984.
Punglia RS, et al. (2003). Effect of verification bias
on screening for prostate cancer by measurement of prostate-specific antigen.
New England Journal of Medicine, 349(4):
335–342.
Scher HI, et al. (2005). Cancer of the prostate. In VT
DeVita Jr et al., eds., Cancer: Principles and Practice of
Oncology, 7th ed., pp. 1192–1259. Philadelphia: Lippincott Williams
and Wilkins.
Long JP, et al. (2001). Five-year retrospective, multi-institutional pooled analysis of cancer-related outcomes after cryosurgical ablation of the prostate. Urology, 57(3): 518–523.
Thompson IM, et al. (2003). The influence of
finasteride on the development of prostate cancer. New England
Journal of Medicine, 349(3): 213–222.
Roberts RO, et al. (2002). A population-based study of
daily nonsteroidal anti-inflammatory drug use and prostate cancer.
Mayo Clinic Proceedings, 77(3): 217–218.
Schoonen WM, et al. (2005). Alcohol consumption and
risk of prostate cancer in middle-aged men. International
Journal of Cancer, 113(1): 133–140.
Other Works Consulted
Carroll PR, et al. (2004). Fourth international
conference on innovations and challenges in prostate cancer: Prevention,
detection, and treatment. Journal of Urology, 172(5):
S3–S5.
D'Amico AV, et al. (2004). 6-month androgen
suppression plus radiation therapy vs. radiation therapy alone for patients
with clinically localized prostate cancer. JAMA, 292(7):
821–827.
McNeel DG, Malkovsky M (2005). Immune-based therapies
for prostate cancer. Immunology Letters, 96(1):
3-9.
National Comprehensive Cancer Network and the American
Cancer Society (2004). Prostate Cancer: Clinical Practice
Guidelines in Oncology, version 1.2004. Jenkintown, PA: National
Comprehensive Cancer Network.
Credits
| Author | Kathe Gallagher, MSW |
| Author | Ralph Poore |
| Editor | Kathleen M. Ariss, MS |
| Editor | Renée Spengler, RN, BSN |
| Associate Editor | Michele Cronen |
| Associate Editor | Terrina Vail |
| Primary Medical Reviewer | Martin Gabica, MD
- Family Medicine |
| Primary Medical Reviewer | Kathleen Romito, MD
- Family Medicine |
| Specialist Medical Reviewer | Christopher G. Wood, MD, FACS
- Urology/Oncology |
| Last Updated | July 24, 2006 |
